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j Advanced CHAIN OF CUSTODY ECORD <br /> -- f�Z orb <br /> GeoEnvironmental, Inc. Date Page of <br /> L!� t <br /> 837 Shaw Road-Stockton, California-85215- (209)467-1006• Fax (209)467-1116 S <br /> Client ,PAAL C4�7 Pro' Mana er <br /> L eTequired <br /> Phone Num <br /> Samplers: Signatu� � Irnoice: <br /> Project Name I VY � AGE <br /> Cliem <br /> Sample Location Sample Type <br /> Number Description Date Time Water Air Solid Coms. / Notes <br /> Comp. Grab. �� <br /> gx-65 u&7-- U-27-62 12i59 <br /> US -h,(- <br /> US PAD /Z-*(? ?C <br /> I u5'Z- W( USt'Z 7ff YI $ <br /> I llS -Ooh S -27� lb ob X ID <br /> - <br /> e inquis a /J/fin re starve y: ignature ale/Time <br /> Relinquished by: (Signature) Received by: (Signature) ((11 Date/Time <br /> yu.�lJSI i ltC,i <br /> Relinquished by: (Signature) Received by Mobilo Laboratory for field analysis: (Signature) � Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: <br /> Data/Time <br /> R' � il• 9--Z Loo <br /> Method of Shipment: n Laboratory me <br /> Special Instructions: 1 her, <br /> ebyauthorize the performance of the above indicated work. <br /> F/� <br />